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Champeaux Depond C, Zouaoui S, Darlix A, Rigau V, Mathieu-Daudé H, Bauchet F, Khettab M, Trétarre B, Figarella-Branger D, Taillandier L, Boetto J, Pallud J, Peyre M, Lottin M, Bauchet L. Descriptive epidemiology of 399 histologically confirmed newly diagnosed meningeal solitary fibrous tumours and haemangiopericytomas in France: 2006-2015. Acta Neurochir (Wien) 2024; 166:320. [PMID: 39093339 DOI: 10.1007/s00701-024-06191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Meningeal solitary fibrous tumour (SFT) and haemangiopericytoma (HPC) are uncommon tumours that have been merged into a single entity in the last 2021 WHO Classification of Tumors of the Central Nervous System. To describe the epidemiology of SFT/HPC operated in France and, to assess their incidence. METHODS We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed SFT/HPC between 2006 and 2015. RESULTS Our study included 399 SFT/HPC patients, operated in France between 2006 and 2015, in one of the 46 participating neurosurgical centres. The incidence reached 0.062, 95%CI[0.056-0.068] for 100,000 person-years. SFT accounted for 35.8% and, HPC for 64.2%. The ratio of SFT/HPC over meningioma operated during the same period was 0.013. SFT/HPC are about equally distributed in women and men (55.9% vs. 44.1%). For the whole population, mean age at surgery was 53.9 (SD ± 15.8) years. The incidence of SFT/HPC surgery increases with the age and, is maximal for the 50-55 years category. Benign SFT/HPC accounted for 65.16%, SFT/HPC of uncertain behaviour for 11.53% and malignant ones for 23.31%. The number of resection progresses as the histopathological behaviour became more aggressive. 6.7% of the patients with a benign SFT/HPC had a second surgery vs.16.6% in case of uncertain behaviour and, 28.4% for malignant SFT/HPC patients. CONCLUSION Meningeal SFT and HPC are rare CNS mesenchymal tumours which both share common epidemiological characteristics, asserting their merging under a common entity. SFT/HPC incidence is less that one case for 1 billion per year and, for around 100 meningiomas-like tumours removed, one SFT/HPC may be diagnosed. SFT/HPC are equally distributed in women and men and, are mainly diagnosed around 50-55 years. The more aggressive the tumour, the higher the probability of recurrence.
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Affiliation(s)
- Charles Champeaux Depond
- Department of Neurosurgery, Hôpital Privé Clairval - Ramsay Santé, 317 Bd de Redon, 13009, Marseille, France.
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier Cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
| | - Amélie Darlix
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Department, Institut du Cancer de Montpellier, University of Montpellier, 34298, Montpellier, France
| | - Valérie Rigau
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Department of Pathology, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier Cedex 5, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier Cedex 5, France
| | - Fabienne Bauchet
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier Cedex 5, France
| | - Mohamed Khettab
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Unit, CHU de La Réunion, Université de La Réunion, 97410, Saint Pierre, France
| | - Brigitte Trétarre
- Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier Cedex 5, France
| | - Dominique Figarella-Branger
- APHM, CNRS, INP, Institut de Neurophysiopathologie, CHU Timone, Service d'Anatomie Pathologique Et de Neuropathologie, Aix-Marseille University, 13005, Marseille, France
| | - Luc Taillandier
- Department of Neurology, University Hospital of Nancy, Nancy, France
| | - Julien Boetto
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier Cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- CRICM INSERM U1127, CNRS UMR 7225, Paris Brain Institute, Sorbonne Université, 75013, Paris, France
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie Et Neurosciences, F-75014, Site Sainte AnneParis, France
- Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université Paris Cité, F-75014, Paris, France
| | - Mathieu Peyre
- Department of Neurosurgery, Bâtiment Babinski, Groupe Hospitalier Pitié-Salpêtrière, APHP, Sorbonne Universités, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- Genetics and Development of Brain Tumors, CRICM INSERM U1127 CNRS UMR 7225, Hôpital de La Pitié-Salpêtrière, Brain Institute, Paris, France
| | - Marine Lottin
- Department of Oncology, Amiens University Hospital, 80054, Amiens, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier Cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
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Virbel G, Mallereau CH, Lhermitte B, Feuvret L, Biau J, Clément L, Khoury C, Bernier V, Milhade N, Tanguy R, Colin P, Cébula H, Proust F, Bauchet L, Noël G. Radiotherapy for central neurocytoma: A multicentric retrospective study in France. Cancer Radiother 2024; 28:365-372. [PMID: 39095224 DOI: 10.1016/j.canrad.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Neurocytomas represent 0.25 to 0.5% of primary brain tumours and are mainly found in young adults. These tumours have neuronal differentiation. The cornerstone treatment is neurosurgery. The efficacy of other therapies, including radiotherapy, is still unclear. The objective of this study was to evaluate the management of central neurocytomas and the role of radiotherapy. MATERIALS AND METHODS All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included. RESULTS One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found. CONCLUSION The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.
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Affiliation(s)
- Guillaume Virbel
- Department of Radiation Oncology, Unicancer, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France
| | | | - Benoît Lhermitte
- Department of Anatomopathology, CHU de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - Loïc Feuvret
- Department of Radiation Oncology, CHU de Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Julian Biau
- Department of Radiation Oncology, centre de lute contre le cancer Jean-Perrin, Unicancer, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - Laurie Clément
- Department of Radiation Oncology, CHU Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France
| | - Cédric Khoury
- Department of Radiation Oncology, centre de radiothérapie Saint-Louis Croix-Rouge française, 150, rue Nicolas-Appert, 83100 Toulon, France
| | - Valérie Bernier
- Department of Radiation Oncology, institut du cancer de Lorraine - Alexis-Vautrin, Unicancer, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - Nicolas Milhade
- Department of Radiation Oncology, institut Bergonié, Unicancer, 229, cour de l'Argonne, 33076 Bordeaux, France
| | - Ronan Tanguy
- Department of Radiation Oncology, centre Léon-Bérard, Unicancer, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - Philippe Colin
- Department of Radiation Oncology, polyclinique Courlancy, 38, rue de Courlancy, 51100 Reims, France
| | - Hélène Cébula
- Department of Neurosurgery, CHU de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - François Proust
- Department of Neurosurgery, CHU de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - Luc Bauchet
- Department of Neurosurgery, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France; IGF, Inserm U1191, Montpellier, France
| | - Georges Noël
- Department of Radiation Oncology, Unicancer, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France.
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Champeaux Depond C, Bauchet L, Elhairech D, Tuppin P, Jecko V, Weller J, Metellus P. Survival After Newly-Diagnosed High-Grade Glioma Surgery: What Can We Learn From the French National Healthcare Database? Brain Tumor Res Treat 2024; 12:162-171. [PMID: 39109617 PMCID: PMC11306842 DOI: 10.14791/btrt.2024.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/30/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND This study aimed to assess the overall survival (OS) of patients after high-grade glioma (HGG) resection and to search for associated prognostic factors. METHODS A random sample of ad hoc cases was extracted from the French medico-administrative national database, Système National des Données de Santé (SNDS). We solely considered the patients who received chemoradiotherapy with temozolomide (TMZ/RT) after HGG surgery. Statistical survival methods were implemented. RESULTS A total of 1,438 patients who had HGG resection at 58 different institutions between 2008 and 2019 were identified. Of these, 34.8% were female, and the median age at HGG resection was 63.2 years (interquartile range [IQR], 55.6-69.4 years). Median OS was 1.69 years (95% confidence interval [CI], 1.63-1.76), i.e., 20.4 months. Median age at death was 65.5 years (IQR, 58.5-71.8). OS at 1, 2, and 5 years was 78.5% (95% CI, 76.4-80.7), 40.3% (95% CI, 37.9-43), and 11.8% (95% CI, 10.2-13.6), respectively. In the adjusted Cox regression, female gender (HR=0.71; 95% CI, 0.63-0.79; p<0.001), age at HGG surgery (HR=1.02; 95% CI, 1.02-1.03; p<0.001), TMZ treatment over 6 months after HGG surgery (HR=0.36; 95% CI, 0.32-0.4; p<0.001), bevacizumab (HR=1.22; 95% CI, 1.09-1.37; p<0.001), and redo surgery (HR=0.79; 95% CI, 0.67-0.93; p=0.005) remained significantly associated with the outcome. CONCLUSION The SNDS is a reliable source for studying the outcome of HGG patients. OS is better in younger patient, female gender, and those who complete concomitant chemoradiotherapy. Redo surgery for HGG recurrence was also associated with prolonged survival.
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Affiliation(s)
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Dahmane Elhairech
- Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, Marseille, France
| | - Philippe Tuppin
- Direction de la Stratégie, des Etudes et des Statistiques, Caisse Nationale de L'Assurance Maladie, Paris, France
| | - Vincent Jecko
- Department of Neurosurgery, Pellegrin Hospital, Bordeaux, France
| | - Joconde Weller
- Direction de l'Information Médicale, Prospectives et Data Sciences (DIMData), Hôpital Saint-Joseph, Paris, France
| | - Philippe Metellus
- Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, Marseille, France
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Depond CC, Zouaoui S, Darlix A, Rigau V, Mathieu-Daudé H, Bauchet F, Khettab M, Trétarre B, Figarella-Branger D, Taillandier L, Boetto J, Pallud J, Zemmoura I, Roche PH, Bauchet L. Descriptive epidemiology of 30,223 histopathologically confirmed meningiomas in France: 2006-2015. Acta Neurochir (Wien) 2024; 166:214. [PMID: 38740641 DOI: 10.1007/s00701-024-06093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/13/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Meningioma is one of the most common neoplasm of the central nervous system. To describe the epidemiology of meningioma operated in France and, to assess grading and histopathological variability among the different neurosurgical centres. METHODS We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed meningiomas between 2006 and 2015. RESULTS 30,223 meningiomas cases were operated on 28,424 patients, in 61 centres. The average number of meningioma operated per year in France was 3,022 (SD ± 122). Meningioma was 3 times more common in women (74.1% vs. 25.9%). The incidence of meningioma increased with age and, mean age at surgery was 58.5 ± 13.9 years. Grade 1, 2, and 3 meningiomas accounted for 83.9%, 13.91% and, 2.19% respectively. There was a significant variability of meningioma grading by institutions, especially for grade 2 which spanned from 5.1% up to 22.4% (p < 0.001). Moreover, the proportion of grade 2 significantly grew over the study period (p < 0.001). There was also a significant variation in grade 1 subtypes diagnosis among the institutions (p < 0.001). 89.05% of the patients had solely one meningioma surgery, 8.52% two and, 2.43% three or more. The number of surgeries was associated to the grade of malignancy (p < 0.001). CONCLUSION The incidence of meningioma surgery increased with age and, peaked at 58.5 years. They were predominantly benign with meningothelial subtype being the most common. However, there was a significant variation of grade 1 subtypes diagnosis among the centres involved. The proportion of grade 2 meningioma significantly grew over the study time, on contrary to malignant meningioma proportion, which remained rare and, stable over time around 2%. Likewise, there was a significant variability of grade 2 meningioma rate among the institutions.
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Affiliation(s)
- Charles Champeaux Depond
- Department of Neurosurgery, Hôpital Privé Clairval - Ramsay Santé, 317 Bd de Redon, 13009, Marseille, France.
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
| | - Amélie Darlix
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Department, Institut du Cancer de Montpellier, University of Montpellier, 34298, Montpellier, France
| | - Valérie Rigau
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Department of Pathology, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Fabienne Bauchet
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Mohamed Khettab
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Unit, CHU de La Réunion, Université de La Réunion, 97410, Saint Pierre, France
| | - Brigitte Trétarre
- Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Dominique Figarella-Branger
- Institut de Neurophysiopathologie, Service d'Anatomie Pathologique Et de Neuropathologie, Aix-Marseille University, APHM, CNRS, INP, CHU Timone, 13005, Marseille, France
| | - Luc Taillandier
- Department of Neurology, University Hospital of Nancy, Nancy, France
| | - Julien Boetto
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Paris Brain Institute, Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, 75013, Paris, France
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie Et Neurosciences, Site Sainte Anne, 75014, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, 75014, Paris, France
| | - Ilyess Zemmoura
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Pierre-Hugues Roche
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie de L'hôpital Nord, APHM - AMU, Marseille, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
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Antoni D, Feuvret L, Biau J, Robert C, Mazeron JJ, Noël G. Radiation guidelines for gliomas. Cancer Radiother 2021; 26:116-128. [PMID: 34953698 DOI: 10.1016/j.canrad.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Gliomas are the most frequent primary brain tumour. The proximity of organs at risk, the infiltrating nature, and the radioresistance of gliomas have to be taken into account in the choice of prescribed dose and technique of radiotherapy. The management of glioma patients is based on clinical factors (age, KPS) and tumour characteristics (histology, molecular biology, tumour location), and strongly depends on available and associated treatments, such as surgery, radiation therapy, and chemotherapy. The knowledge of molecular biomarkers is currently essential, they are increasingly evolving as additional factors that facilitate diagnostics and therapeutic decision-making. We present the update of the recommendations of the French society for radiation oncology on the indications and the technical procedures for performing radiation therapy in patients with gliomas.
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Affiliation(s)
- D Antoni
- Service de radiothérapie, institut cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg cedex, France.
| | - L Feuvret
- Service de radiothérapie, CHU Pitié-Salpêtrière, Assistance publique-hôpitaux de Paris (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - J Biau
- Département universitaire de radiothérapie, centre Jean-Perrin, Unicancer, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 01, France
| | - C Robert
- Département de radiothérapie, institut de cancérologie Gustave-Roussy, 39, rue Camille-Desmoulin, 94800 Villejuif, France
| | - J-J Mazeron
- Service de radiothérapie, CHU Pitié-Salpêtrière, Assistance publique-hôpitaux de Paris (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - G Noël
- Service de radiothérapie, institut cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg cedex, France
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Characteristics and management of hydrocephalus in adult patients with cerebellar glioblastoma: lessons from a French nationwide series of 118 cases. Neurosurg Rev 2021; 45:683-699. [PMID: 34195892 DOI: 10.1007/s10143-021-01578-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
The characteristics of hydrocephalus associated with cerebellar glioblastoma (cGB) remain poorly known. The objectives were to describe the occurence of hydrocephalus in a French nationwide series of adult patients with cGB, to identify the characteristics associated with hydrocephalus and to analyze the outcomes associated with the different surgical strategies, in order to propose practical guidelines. Consecutive cases of adult cGB patients prospectively recorded into the French Brain Tumor Database between 2003 and 2017 were screened. Diagnosis was confirmed by a centralized neuropathological review. Among 118 patients with cGB (mean age 55.9 years), 49 patients (41.5%) presented with pre-operative hydrocephalus. Thirteen patients (11.0%) developed acute (n=7) or delayed (n=6) hydrocephalus postoperatively. Compared to patients without hydrocephalus at admission, patients with hydrocephalus were younger (52.0 years vs 58.6 years, p=0.03) and underwent more frequently tumor resection (93.9% vs 73.9%, p=0.006). A total of 40 cerebrospinal-fluid diversion procedures were performed, including 18 endoscopic third ventriculostomies, 12 ventriculoperitoneal shunts and 10 external ventricular drains. The different cerebrospinal-fluid diversion options had comparable functional results and complication rates. Among the 89 patients surgically managed for cGB without prior cerebrospinal-fluid diversion, 7 (7.9%) were long-term shunt-dependant. Hydrocephalus is frequent in patients with cGB and has to be carefully managed in order not to interfere with adjuvant oncological treatments. In case of symptomatic hydrocephalus, a cerebrospinal-fluid diversion is mandatory, especially if surgical resection is not feasible. In case of asymptomatic hydrocephalus, a cerebrospinal-fluid diversion has to be discussed only if surgical resection is not feasible.
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Papillary meningioma of the central nervous system: a SEER database analysis. Neurosurg Rev 2021; 44:2777-2784. [PMID: 33415520 DOI: 10.1007/s10143-020-01449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/06/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023]
Abstract
Papillary meningioma (PM) is a rare central nervous system tumor. We aimed to analyze the characteristics and outcomes of patients with PM (WHO grade III) and identify risk factors that influence survival using the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics, tumor features, and outcomes of 108 PM patients included in the SEER database between 1990 and 2016 were retrieved. Risk factors related to prognosis of PM were assessed by Kaplan-Meier curves and the Cox proportional hazards model. All 108 patients, including 65 males and 43 females (1.5:1), with a median age of 52 years (range, 9 to > 85 years) had undergone surgical resection. Gross total resection (GTR) was achieved in 50%, and 50% underwent subtotal resection (STR). While 55.6% underwent postoperative radiation therapy, 48% did not. The median disease-specific survival (DSS) was 128 months, and the 5-year DSS rate was 77%. In multivariate analysis, age ≤ 52 years and GTR were both independently associated with higher probability of DSS (p = 0.033 and p = 0.029, respectively). Stratification analysis showed that postoperative radiotherapy had no significant impact on the DSS, irrespective of resection extent (p = 0.172). Our SEER analysis showed that age and extent of resection were prognostic factors for PM, but race, tumor size, gender, chemotherapy, and postoperative radiotherapy did not significantly impact DSS of PM patients. There was no significant improvement in survival of patients who underwent radiotherapy and GTR, or radiotherapy and STR, compared with GTR or STR alone.
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Picart T, Meyronet D, Pallud J, Dumot C, Metellus P, Zouaoui S, Berhouma M, Ducray F, Bauchet L, Guyotat J. Management, functional outcomes and survival in a French multicentric series of 118 adult patients with cerebellar glioblastoma. J Cancer Res Clin Oncol 2021; 147:1843-1856. [PMID: 33399987 DOI: 10.1007/s00432-020-03474-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/18/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To analyze the outcomes and predictors in a large series of cerebellar glioblastomas in order to guide patient management. METHODS The French brain tumor database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively identified adult patients with cerebellar glioblastoma diagnosed between 2003 and 2017. Diagnosis was confirmed by a centralized neuropathological review. RESULTS Data from 118 cerebellar glioblastoma patients were analyzed (mean age 55.9 years, 55.1% males). The clinical presentation associated raised intracranial pressure (50.8%), static cerebellar syndrome (68.6%), kinetic cerebellar syndrome (49.2%) and/or cranial nerve disorders (17.8%). Glioblastomas were hemispheric (55.9%), vermian (14.4%) or both (29.7%). Hydrocephalus was present in 49 patients (41.5%). Histologically, tumors corresponded either to IDH-wild-type or to K27-mutant glioblastomas. Surgery consisted of total (12.7%), subtotal (35.6%), partial resection (33.9%) or biopsy (17.8%). The postoperative Karnofsky performance status was improved, stable and worsened in 22.4%, 43.9% and 33.7% of patients, respectively. Progression-free and overall survivals reached 5.1 months and 9.1 months, respectively. Compared to other surgical strategies, total or subtotal resection improved the Karnofsky performance status (33.3% vs 12.5%, p < 0.001), prolonged progression-free and overall survivals (6.5 vs 4.3 months, p = 0.015 and 16.7 vs 6.2 months, p < 0.001, respectively) and had a comparable complication rate (40.4% vs 31.1%, p = 0.29). After total or subtotal resection, the functional outcomes were correlated with age (p = 0.004) and cerebellar hemispheric tumor location (p < 0.001) but not brainstem infiltration (p = 0.16). CONCLUSION In selected patients, maximal resection of cerebellar glioblastoma is associated with improved onco-functional outcomes, compared with less invasive procedures.
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Affiliation(s)
- Thiébaud Picart
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France.
- Claude Bernard University Lyon 1, Lyon, France.
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France.
| | - David Meyronet
- Claude Bernard University Lyon 1, Lyon, France
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France
- Groupe Hospitalier Est, Department of Neuropathology, Hospices Civils de Lyon, Bron, France
| | - Johan Pallud
- Department of Neurosurgery, Hôpital Sainte-Anne, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMA-Brain, INSERM U894, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Chloé Dumot
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
- Claude Bernard University Lyon 1, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, INSA Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Metellus
- Hôpital Privé Clairval, Ramsay Général de Santé, Marseille, France
- Institut de Neurophysiopathologie, UMR 7051, Université D'Aix-Marseille, Marseille, France
| | - Sonia Zouaoui
- Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
- FBTDB (French Brain Tumor DataBase), Montpellier University Hospital, Montpellier, France
| | - Moncef Berhouma
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
- Claude Bernard University Lyon 1, Lyon, France
- CREATIS Laboratory, Inserm U1206, UMR 5220, Université de Lyon, Villeurbanne, France
| | - François Ducray
- Claude Bernard University Lyon 1, Lyon, France
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France
- Department of Neurooncology, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Luc Bauchet
- Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
- FBTDB (French Brain Tumor DataBase), Montpellier University Hospital, Montpellier, France
- Institut Des Neurosciences de Montpellier, INSERM U1051, Hôpital Saint Eloi, Montpellier, France
| | - Jacques Guyotat
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
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9
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Franceschi E, Frappaz D, Rudà R, Hau P, Preusser M, Houillier C, Lombardi G, Asioli S, Dehais C, Bielle F, Di Nunno V, van den Bent M, Brandes AA, Idbaih A. Rare Primary Central Nervous System Tumors in Adults: An Overview. Front Oncol 2020; 10:996. [PMID: 32676456 PMCID: PMC7333775 DOI: 10.3389/fonc.2020.00996] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/20/2020] [Indexed: 12/15/2022] Open
Abstract
Overall, tumors of primary central nervous system (CNS) are quite common in adults with an incidence rate close to 30 new cases/100,000 inhabitants per year. Significant clinical and biological advances have been accomplished in the most common adult primary CNS tumors (i.e., diffuse gliomas). However, most CNS tumor subtypes are rare with an incidence rate below the threshold defining rare disease of 6.0 new cases/100,000 inhabitants per year. Close to 150 entities of primary CNS tumors have now been identified by the novel integrated histomolecular classification published by the World Health Organization (WHO) and its updates by the c-IMPACT NOW consortium (the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy). While these entities can be better classified into smaller groups either by their histomolecular features and/or by their location, assessing their treatment by clinical trials and improving the survival of patients remain challenging. Despite these tumors are rare, research, and advances remain slower compared to diffuse gliomas for instance. In some cases (i.e., ependymoma, medulloblastoma) the understanding is high because single or few driver mutations have been defined. The European Union has launched European Reference Networks (ERNs) dedicated to support advances on the clinical side of rare diseases including rare cancers. The ERN for rare solid adult tumors is termed EURACAN. Within EURACAN, Domain 10 brings together the European patient advocacy groups (ePAGs) and physicians dedicated to improving outcomes in rare primary CNS tumors and also aims at supporting research, care and teaching in the field. In this review, we discuss the relevant biological and clinical characteristics, clinical management of patients, and research directions for the following types of rare primary CNS tumors: medulloblastoma, pineal region tumors, glioneuronal and rare glial tumors, ependymal tumors, grade III meningioma and mesenchymal tumors, primary central nervous system lymphoma, germ cell tumors, spinal cord tumors and rare pituitary tumors.
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Affiliation(s)
- Enrico Franceschi
- Department of Medical Oncology, Azienda USL/IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Didier Frappaz
- Department of Neuro-Oncology and Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Roberta Rudà
- Department of Neuro-Oncology, City of Health and Science and University of Turin, Turin, Italy
| | - Peter Hau
- Wilhelm Sander NeuroOncology-Unit, Department of Neurology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Caroline Houillier
- Sorbonne Université, IHU, ICM, Service de Neurologie 2-Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Giuseppe Lombardi
- Department of Oncology, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Sofia Asioli
- Section of Anatomic Pathology "M. Malpighi", Department of Biomedical and Neuromotor Sciences, Bellaria Hospital, Bologna, Italy
| | - Caroline Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Franck Bielle
- Department of Neuropathology, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Sorbonne Université, SIRIC Curamus, Paris, France
| | - Vincenzo Di Nunno
- Department of Medical Oncology, Azienda USL/IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Martin van den Bent
- The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Alba A Brandes
- Department of Medical Oncology, Azienda USL/IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Ahmed Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
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10
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Ng S, Zouaoui S, Bessaoud F, Rigau V, Roux A, Darlix A, Bauchet F, Mathieu-Daudé H, Trétarre B, Figarella-Branger D, Pallud J, Frappaz D, Roujeau T, Bauchet L. An epidemiology report for primary central nervous system tumors in adolescents and young adults: a nationwide population-based study in France, 2008-2013. Neuro Oncol 2020; 22:851-863. [PMID: 31796950 PMCID: PMC7283028 DOI: 10.1093/neuonc/noz227] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Primary central nervous system tumors (PCNST) among adolescents and young adults (AYA, 15-39 y) have rarely been reported. We present a nationwide report of PCNST histologically confirmed in the French AYA population between 2008 and 2013. METHODS Patients were identified through the French Brain Tumor Database (FBTDB), a national dataset that includes prospectively all histologically confirmed cases of PCNST in France. Patients aged 15 to 39 years with histologically confirmed PCNST diagnosed between 2008 and 2013 were included. For each of the 143 histological subtypes of PCNST, crude rates, sex, surgery, and age distribution were provided. To enable international comparisons, age-standardized incidence rates were adjusted to the world-standard, European, and USA populations. RESULTS For 6 years, 9661 PCNST (males/females: 4701/4960) were histologically confirmed in the French AYA population. The overall crude rate was 8.15 per 100 000 person-years. Overall, age-standardized incidence rates were (per 100 000 person-years, population of reference: world/Europe/USA): 7.64/8.07/8.21, respectively. Among patients aged 15-24 years, the crude rate was 5.13 per 100 000. Among patients aged 25-39 years, the crude rate was 10.10 per 100 000. Age-standardized incidence rates were reported for each of the 143 histological subtypes. Moreover, for each histological subtype, data were detailed by sex, age, type of surgery (surgical resection or biopsy), and cryopreserved samples. CONCLUSION These data represent an exhaustive report of all histologically confirmed cases of PCNST with their frequency and distribution in the French AYA population in 2008-2013. For the first time in this age group, complete histological subtypes and rare tumor identification are detailed.
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Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Faiza Bessaoud
- Tumor Registry of the Hérault, Institut du Cancer de Montpellier, Montpellier, France
| | - Valérie Rigau
- Department of Neuropathology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Alexandre Roux
- Department of Neurosurgery, University Hospital Group Paris, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Imaging Biomarkers of Brain Disorders, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Amélie Darlix
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
| | - Fabienne Bauchet
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
| | - Hélène Mathieu-Daudé
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
- Department of Medical Informatics, Institut du Cancer de Montpellier, Montpellier, France
| | - Brigitte Trétarre
- Tumor Registry of the Hérault, Institut du Cancer de Montpellier, Montpellier, France
| | - Dominique Figarella-Branger
- Aix-Marseille University, National Center for Scientific Research, Institute of Neuro-Physiopathology, Marseille, France
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France
| | - Johan Pallud
- Department of Neurosurgery, University Hospital Group Paris, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Imaging Biomarkers of Brain Disorders, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | | | - Thomas Roujeau
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
- National Institute of Health and Medical Research unit 1051, Montpellier, France
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11
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Starnoni D, Berthiller J, Idriceanu TM, Meyronet D, d'Hombres A, Ducray F, Guyotat J. Returning to work after multimodal treatment in glioblastoma patients. Neurosurg Focus 2019; 44:E17. [PMID: 29852767 DOI: 10.3171/2018.3.focus1819] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although multimodal treatment for glioblastoma (GBM) has resulted in longer survival, uncertainties exist regarding health-related quality of life and functional performance. Employment represents a useful functional end point and an indicator of social reintegration. The authors evaluated the rate of patients resuming their employment and the factors related to work capacity. METHODS The authors performed a retrospective study of working-age patients treated with surgery and radiochemotherapy between 2012 and 2015. Data were collected before and after surgery and at 6, 12, 18, and 24 months. Employment was categorized according to the French Socio-Professional Groups and analyzed regarding demographic and clinical data, performance status, socio-professional category, radiological features, type, and quality of resection. RESULTS A total of 125 patients, mean age 48.2 years, were identified. The mean follow-up was 20.7 months with a median survival of 22.9 months. Overall, 21 patients (18.3%) went back to work, most on a part-time basis (61.9%). Of the patients who were alive at 6, 12, 18, and 24 months after diagnosis, 8.7%, 13.8%, 15.3%, and 28.2%, respectively, were working. Patients going back to work were younger (p = 0.03), had fewer comorbidities (p = 0.02), and had a different distribution of socio-professional groups, with more patients belonging to higher occupation categories (p = 0.02). Treatment-related symptoms (36.2%) represented one of the main factors that prevented the resumption of work. Employment was strongly associated with performance status (p = 0.002) as well as gross-total removal (p = 0.04). No statistically significant difference was found regarding radiological or molecular features and the occurrence of complications after surgery. CONCLUSIONS GBM diagnosis and treatment has a significant socio-professional impact with only a minority of patients resuming work, mostly on a part-time basis.
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Affiliation(s)
- Daniele Starnoni
- 1Neurosurgical Department, Oncological and Vascular Service, Pierre Wertheimer University Hospital, Lyon
| | - Julien Berthiller
- 2Clinical Investigation Centre CIC-INSERM 1407, EPICIME, Department of Clinical Pharmacology, Hospices Civils de Lyon
| | - Tania-Mihaela Idriceanu
- 1Neurosurgical Department, Oncological and Vascular Service, Pierre Wertheimer University Hospital, Lyon
| | - David Meyronet
- 4Université Claude Bernard Lyon 1, Lyon.,6Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuropathologie, Lyon; and
| | - Anne d'Hombres
- 7Département de Radiothérapie, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France
| | - François Ducray
- 3Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon.,5Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon
| | - Jacques Guyotat
- 1Neurosurgical Department, Oncological and Vascular Service, Pierre Wertheimer University Hospital, Lyon
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12
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Altunrende ME, Göker B, Dolgun M, Akçakaya MO, Kasımcan MÖ, Şencan F, Hamamcıoğlu MK, Kırış T. Intracranial cystic meningiomas: A series of six patients. Neurocirugia (Astur) 2019; 30:159-166. [PMID: 30792109 DOI: 10.1016/j.neucir.2019.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 10/10/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Although meningiomas are the most common primary non-glial intracranial tumors, cystic meningiomas are quite rare. This study presents six cases in order to discuss the radiological and pathological features of cystic meningiomas. PATIENTS AND METHODS Six patients with cystic meningiomas were included in the study. All patients underwent a cranial computed tomography scan and magnetic resonance imaging (MRI) evaluation, pre- and postoperatively. RESULTS All patients presented with long standing headache dating back at least two years. There was no gender predominance in our series. Radiological evaluation revealed two parasagittal and two convexity meningiomas located at the frontal region. Two lesions were located at the tuberculum sellae and the foramen magnum. All of the tumors were totally excised (Simpson Grade I or II). Pathology results included meningothelial meningioma in three patients, angiomatous meningioma in two patients, and metaplastic meningioma in one patient. In two patients, the cystic meningiomas were resected with the use of sodium fluorescein (Na-Fl) under a YELLOW 560nm microscope filter. Na-Fl was found to be very useful in demonstrating the brain-tumor interface, and it was especially effective in resecting the cyst wall of the peritumoural cystic meningiomas. None of the patients had any complications, and no recurrences were noted in any of the patients within the mean follow-up period of 51 months (range: 16-102 months). CONCLUSION It is important to note MRI changes specific to cystic meningioma and include meningiomas in the differential diagnosis of intracranial cystic lesions. The use of sodium fluorescein (Na-Fl) under a YELLOW 560nm microscope filter is a useful tool to differentiate the brain-tumor interface, as well as to identify the cyst wall in order to fully resect the tumor with the cystic component to avoid recurrence and achieve better clinical results.
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Affiliation(s)
- Muhittin Emre Altunrende
- Department of Neurosurgery, GOP Taksim Training and Research Hospital, Istanbul, Turkey; Department of Neurosurgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Burcu Göker
- Department of Neurosurgery, Istinye University Medical Faculty, Liv Hospital, Istanbul, Turkey
| | - Müge Dolgun
- Department of Neurosurgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Osman Akçakaya
- Department of Neurosurgery, Istinye University Medical Faculty, Liv Hospital, Istanbul, Turkey.
| | - Mustafa Ömür Kasımcan
- Department of Neurosurgery, Istinye University Medical Faculty, Liv Hospital, Istanbul, Turkey
| | - Fahir Şencan
- Department of Neurosurgery, Istinye University Medical Faculty, Liv Hospital, Istanbul, Turkey
| | | | - Talat Kırış
- Department of Neurosurgery, Istinye University Medical Faculty, Liv Hospital, Istanbul, Turkey
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13
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Terrier LM, Bauchet L, Rigau V, Amelot A, Zouaoui S, Filipiak I, Caille A, Almairac F, Aubriot-Lorton MH, Bergemer-Fouquet AM, Bord E, Cornu P, Czorny A, Dam Hieu P, Debono B, Delisle MB, Emery E, Farah W, Gauchotte G, Godfraind C, Guyotat J, Irthum B, Janot K, Le Reste PJ, Liguoro D, Loiseau H, Lot G, Lubrano V, Mandonnet E, Menei P, Metellus P, Milin S, Muckenstrum B, Roche PH, Rousseau A, Uro-Coste E, Vital A, Voirin J, Wager M, Zanello M, François P, Velut S, Varlet P, Figarella-Branger D, Pallud J, Zemmoura I. Natural course and prognosis of anaplastic gangliogliomas: a multicenter retrospective study of 43 cases from the French Brain Tumor Database. Neuro Oncol 2018; 19:678-688. [PMID: 28453747 DOI: 10.1093/neuonc/now186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022] Open
Abstract
Background Anaplastic gangliogliomas (GGGs) are rare tumors whose natural history is poorly documented. We aimed to define their clinical and imaging features and to identify prognostic factors. Methods Consecutive cases of anaplastic GGGs in adults prospectively entered into the French Brain Tumor Database between March 2004 and April 2014 were screened. After diagnosis was confirmed by pathological review, clinical, imaging, therapeutic, and outcome data were collected retrospectively. Results Forty-three patients with anaplastic GGG (median age, 49.4 y) from 18 centers were included. Presenting symptoms were neurological deficit (37.2%), epileptic seizure (37.2%), or increased intracranial pressure (25.6%). Typical imaging findings were unifocal location (94.7%), contrast enhancement (88.1%), central necrosis (43.2%), and mass effect (47.6%). Therapeutic strategy included surgical resection (95.3%), adjuvant radiochemotherapy (48.8%), or radiotherapy alone (27.9%). Median progression-free survival (PFS) and overall survival (OS) were 8.0 and 24.7 months, respectively. Three- and 5-year tumor recurrence rates were 69% and 100%, respectively. The 5-year survival rate was 24.9%. Considering unadjusted significant prognostic factors, tumor midline crossing and frontal location were associated with shorter OS. Temporal and parietal locations were associated with longer and shorter PFS, respectively. None of these factors remained statistically significant in multivariate analysis. Conclusions We report a large series providing clinical, imaging, therapeutic, and prognostic features of adult patients treated for an intracerebral anaplastic GGG. Our results show that pathological diagnosis is difficult, that survivals are only slightly better than for glioblastomas, and that complete surgical resection followed with adjuvant chemoradiotherapy offers longer survival.
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Affiliation(s)
- Louis-Marie Terrier
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
| | - Luc Bauchet
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.,French Brain Tumor DataBase, ICM, Montpellier, France
| | - Valérie Rigau
- French Brain Tumor DataBase, ICM, Montpellier, France.,Department of Neuropathology and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France
| | - Aymeric Amelot
- Department of Neurosurgery, Hôpital La Pitié Salpétrière, APHP, Paris, France
| | - Sonia Zouaoui
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.,French Brain Tumor DataBase, ICM, Montpellier, France
| | - Isabelle Filipiak
- Plateforme CIRE, UMR-PRC, 37380 Nouzilly, Centre INRA Val de Loire, France
| | - Agnès Caille
- Université François-Rabelais de Tours, Tours, France.,Inserm, CIC 1415, CHRU de Tours, Tours, France.,Service de Neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France
| | - Fabien Almairac
- Department of Neurosurgery, Hôpital Pasteur, University Hospital Center, 06000, Nice, France
| | - Marie-Hélène Aubriot-Lorton
- Department of Pathology, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France
| | | | - Eric Bord
- Department of Neurosurgery and Neurotraumatology, Nantes University Hospital, Nantes, France
| | - Philippe Cornu
- Department of Neurosurgery, Hôpital La Pitié Salpétrière, APHP, Paris, France
| | - Alain Czorny
- Service de Neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France
| | - Phong Dam Hieu
- Department of Neurosurgery, CHU de la Cavale Blanche, Brest, France
| | - Bertrand Debono
- Department of Neurosurgery, Cèdres Hospital, Toulouse, France
| | - Marie-Bernadette Delisle
- Laboratoire Universitaire d'Anatomie Patholgique, Neuropathologie humaine et expérimentale, CHU Rangueil, Toulouse, France
| | - Evelyne Emery
- Department of Neurosurgery, University Hospital of Caen, Caen, France
| | - Walid Farah
- Service de Neurochirurgie, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France
| | - Guillaume Gauchotte
- Department of Pathology, CHU Nancy and INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | | | - Jacques Guyotat
- Department of Neurosurgery, Neurological Hospital, Lyon, France
| | - Bernard Irthum
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - Kevin Janot
- Service de Neuroradiologie, CHRU de Tours, Tours, France
| | - Pierre-Jean Le Reste
- Department of Neurosurgery, University Hospital Pontchaillou, 2, Rue Henri Le Guilloux, 35000, Rennes, France
| | - Dominique Liguoro
- Service de neurochirurgie A, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - Hugues Loiseau
- Université de Bordeaux - Service de Neurochirurgie B, hôpital Pellegrin Tripode, Bordeaux, France
| | - Guillaume Lot
- Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France
| | - Vincent Lubrano
- Service de neurochirurgie, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA, Toulouse, France
| | | | - Philippe Menei
- Département de neurochirurgie, CHU d'Angers, 4, rue Larrey, 49940 Angers cedex 9, France
| | - Philippe Metellus
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - Serge Milin
- Department of Pathology, CHU de Poitiers, Hôpital la Milétrie, Poitiers, France
| | | | - Pierre-Hugues Roche
- Service de Neurochirurgie, Hôpital Nord, APHM, University Hospital of Marseille Aix-Marseille Univ, Marseille, France
| | - Audrey Rousseau
- Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalo-universitaire d'Angers, 4 rue Larrey, Angers Cedex, France
| | - Emmanuelle Uro-Coste
- CHU Toulouse, Hôpital de Rangueil, Service d'Anatomie et Cytologie Pathologique, Toulouse, France
| | - Anne Vital
- Bordeaux Institute of Neuroscience, CNRS UMR 5227, F-33076, Bordeaux, France
| | - Jimmy Voirin
- Department of Neurosurgery, Strasbourg-Colmar Hospital, France
| | - Michel Wager
- Department of Neurosurgery, Imaging Laboratory, University Hospital Poitiers, 2 Rue de La Miletrie, Poitiers Cedex, France
| | - Marc Zanello
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neurosurgery, Sainte-Anne Hospital, Paris, France
| | | | - Stéphane Velut
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
| | - Pascale Varlet
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neuropathology, Sainte-Anne Hospital, Paris, France
| | | | - Johan Pallud
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neurosurgery, Sainte-Anne Hospital, Paris, France
| | - Ilyess Zemmoura
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
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14
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Zouaoui S, Darlix A, Rigau V, Mathieu-Daudé H, Bauchet F, Bessaoud F, Fabbro-Peray P, Trétarre B, Figarella-Branger D, Taillandier L, Loiseau H, Bauchet L. Descriptive epidemiology of 13,038 newly diagnosed and histologically confirmed meningiomas in France: 2006–2010. Neurochirurgie 2018; 64:15-21. [DOI: 10.1016/j.neuchi.2014.11.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 11/10/2014] [Accepted: 11/29/2014] [Indexed: 10/23/2022]
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15
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Rivoirard R, Vallard A, Boutet C, Falk AT, Garin C, Adjabi A, Hoarau D, Forest F, Fotso MJ, Rancoule C, Magné N. A retrospective survey of the last 3 months of life in patients carrying glioblastoma: Clinical treatments and profiles. Mol Clin Oncol 2018; 8:115-120. [PMID: 29387402 DOI: 10.3892/mco.2017.1479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022] Open
Abstract
Glioblastoma is one of the most common types of primary brain tumor. In situations of local recurrence, physicians can suggest either specific palliative anticancer treatments (SPAT; surgery, chemotherapy, radiotherapy) or best supportive care (BSC). The objective of the present study was to identify clinical factors that may have influenced the continuation or cessation of SPAT during the final 3 months of life in patients with glioblastoma. In the present retrospective single-center study, all records of patients treated for glioblastoma, who succumbed to the disease between June 2006 and February 2014, were assessed. All selected patients were divided into two groups, according to treatments received during the last 3 months of life: The SPAT and BSC groups. A total of 148 patients were included: 81 patients in the SPAT group (group A) and 67 patients in the BSC group (group B). A performance status equal to 0 was observed for 17.3% of patients in group A vs. 6% in group B. Following progression, chemotherapy was administered in 39.5% of cases in group A vs. 20.9% of cases in group B (P=0.0149). The mean number of lines of chemotherapy administered in group A was equal to 1.44±0.77 as compared with 1.06±0.67 in group B (P=0.0017). SPAT are utilized frequently among patients approaching mortality due to a glioblastoma. Certain factors, including the utilization of novel chemotherapy after the first progression or number of lines of chemotherapy previously administered, may have influenced physicians' decisions whether to continue with the SPAT or not.
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Affiliation(s)
- Romain Rivoirard
- Department of Medical Oncology, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Alexis Vallard
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Claire Boutet
- Department of Morphological and Functional Imaging, St. Etienne North Hospital, 42270 Saint Priest en Jarez, France
| | - Alexander Tuan Falk
- Departement of Radiation Oncology, Centre Antoine Lacassagne, 06100 Nice, France
| | - Clemence Garin
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Anissa Adjabi
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Delphine Hoarau
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Fabien Forest
- Anatomopathology Laboratory, CHU Saint Etienne, 42270 Saint Priest en Jarez, France
| | | | - Chloe Rancoule
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
| | - Nicolas Magné
- Department of Radiotherapy, Lucien Neuwirth Institute of Cancerology, 42270 Saint Priest en Jarez, France
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16
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Grenier JK, Foureman PA, Sloma EA, Miller AD. RNA-seq transcriptome analysis of formalin fixed, paraffin-embedded canine meningioma. PLoS One 2017; 12:e0187150. [PMID: 29073243 PMCID: PMC5658167 DOI: 10.1371/journal.pone.0187150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/14/2017] [Indexed: 12/21/2022] Open
Abstract
Meningiomas are the most commonly reported primary intracranial tumor in dogs and humans and between the two species there are similarities in histology and biologic behavior. Due to these similarities, dogs have been proposed as models for meningioma pathobiology. However, little is known about specific pathways and individual genes that are involved in the development and progression of canine meningioma. In addition, studies are lacking that utilize RNAseq to characterize gene expression in clinical cases of canine meningioma. The primary objective of this study was to develop a technique for which high quality RNA can be extracted from formalin-fixed, paraffin embedded tissue and then used for transcriptome analysis to determine patterns of gene expression. RNA was extracted from thirteen canine meningiomas-eleven from formalin fixed and two flash-frozen. These represented six grade I and seven grade II meningiomas based on the World Health Organization classification system for human meningioma. RNA was also extracted from fresh frozen leptomeninges from three control dogs for comparison. RNAseq libraries made from formalin fixed tissue were of sufficient quality to successfully identify 125 significantly differentially expressed genes, the majority of which were related to oncogenic processes. Twelve genes (AQP1, BMPER, FBLN2, FRZB, MEDAG, MYC, PAMR1, PDGFRL, PDPN, PECAM1, PERP, ZC2HC1C) were validated using qPCR. Among the differentially expressed genes were oncogenes, tumor suppressors, transcription factors, VEGF-related genes, and members of the WNT pathway. Our work demonstrates that RNA of sufficient quality can be extracted from FFPE canine meningioma samples to provide biologically relevant transcriptome analyses using a next-generation sequencing technique, such as RNA-seq.
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Affiliation(s)
- Jennifer K. Grenier
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States of America
| | - Polly A. Foureman
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States of America
- Division of Biological Sciences, Chandler-Gilbert Community College, Chandler, Arizona, United States of America
| | - Erica A. Sloma
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States of America
| | - Andrew D. Miller
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States of America
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17
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EGFR Amplification and IDH Mutations in Glioblastoma Patients of the Northeast of Morocco. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8045859. [PMID: 28785587 PMCID: PMC5530437 DOI: 10.1155/2017/8045859] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/11/2017] [Indexed: 02/06/2023]
Abstract
Glioblastomas are the most frequent and aggressive primary brain tumors which are expressing various evolutions, aggressiveness, and prognosis. Thus, the 2007 World Health Organization classification based solely on the histological criteria is no longer sufficient. It should be complemented by molecular analysis for a true histomolecular classification. The new 2016 WHO classification of tumors of the central nervous system uses molecular parameters in addition to histology to reclassify these tumors and reduce the interobserver variability. The aim of this study is to determine the prevalence of IDH mutations and EGFR amplifications in the population of the northeast region of Morocco and then to compare the results with other studies. Methods. IDH1 codon 132 and IDH2 codon 172 were directly sequenced and the amplification of exon 20 of EGFR gene was investigated by qPCR in 65 glioblastoma tumors diagnosed at the University Hospital of Fez between 2010 and 2014. Results. The R132H IDH1 mutation was observed in 8 of 65 tumor samples (12.31%). No mutation of IDH2 was detected. EGFR amplification was identified in 17 cases (26.15%). Conclusion. A systematic search of both histological and molecular markers should be requisite for a good diagnosis and a better management of glioblastomas.
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18
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Frappaz D, Le Rhun E, Dagain A, Averland B, Bauchet L, Faure A, Guillaume C, Zouaoui S, Provot F, Vachiery F, Taillandier L, Hoang-Xuan K. [Recommendations for the organ donation from patients with brain or medullary primitive tumors on behalf of the Association of the Neuro-oncologists of French Expression (ANOCEF) and the Club of Neuro-oncology of the French Society of Neurosurgery]. Bull Cancer 2017; 104:771-788. [PMID: 28549594 DOI: 10.1016/j.bulcan.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 11/18/2022]
Abstract
Requests of organs to be transplanted increase. As a matter of urgency, it is not always easy to decide if a patient carrier of a brain tumor can be candidate in the donation. After a review of the literature, the members of the Association of the Neuro-oncologists of French Expression (ANOCEF) and the Club of Neuro-oncology of the French Society of Neurosurgery propose consensual recommendations in case of donor carrier of primitive tumor intra-cranial or intra-medullary. A contact with the neuro-oncologist/neurosurgeon will allow to discuss the indication in case of glioma of grade I/II/III, according to the grade, the current status (absence of progressive disease), the number of surgeries and of lines of treatment. The taking is disadvised in case of glioma of grade IV (glioblastoma), of lymphoma or meningioma of grade III. No contraindication for the meningiomas of grade I, and individual discussion for the meningiomas of grade II. It is advisable to remain careful in case of hemangiopericytoma and of meningeal solitary fibrous tumor. The patients in first complete remission of a medulloblastoma or intra-cranial primitive germinoma seem good candidates for the taking of organ if the follow-up is of at least 10 years (3 years for non germinomas). In every case, a multidisciplinary discussion is desirable when it is materially possible.
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Affiliation(s)
- Didier Frappaz
- Centre Léon-Bérard, 28, rue Laennec, 69673 Lyon, France.
| | - Emilie Le Rhun
- University hospital, department of neurosurgery, neuro-oncology, 59037 Lille, France; Oscar-Lambret center, department of medical oncology, Breast unit, 59037 Lille, France; Lille university, Inserm U-1192, laboratoire de protéomique, réponse inflammatoire, spectrométrie de masse (PRISM), 59037 Lille, France
| | - Arnaud Dagain
- HIA Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - Benoît Averland
- Agence de la biomédecine, 1, avenue du Stade de France, 93210 Saint-Denis, France
| | - Luc Bauchet
- CHRU Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France
| | | | | | - Sonia Zouaoui
- CHRU Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France
| | | | - Florence Vachiery
- CHRU Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France
| | - Luc Taillandier
- CHU de Nancy, 5, rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France
| | - Khê Hoang-Xuan
- APHP, UMPC-Sorbonne universités, hôpital Pitié-Salpêtrière, 75013 Paris, France
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19
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Abstract
Glioblastomas are serious tumours of the central nervous system. Recurrence is systematic and prognosis poor. Radiotherapy and chemotherapy follow surgery, when surgery is possible, to lengthen survival, while preserving quality of life as much as possible. In this respect, symptomatic treatments and supportive care are necessary.
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Affiliation(s)
- Hugues Duffau
- Hôpital Gui de Chauliac, CHU de Montpellier, 80 avenue Augustin-Fliche, 34 000 Montpellier, France; INSERM U1051, Institut des neurosciences de Montpellier, Hôpital Saint Eloi, CHU de Montpellier, 80 avenue Augustin-Fliche, 34 000 Montpellier, France.
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20
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Darlix A, Zouaoui S, Rigau V, Bessaoud F, Figarella-Branger D, Mathieu-Daudé H, Trétarre B, Bauchet F, Duffau H, Taillandier L, Bauchet L. Epidemiology for primary brain tumors: a nationwide population-based study. J Neurooncol 2016; 131:525-546. [PMID: 27853959 DOI: 10.1007/s11060-016-2318-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/06/2016] [Indexed: 01/20/2023]
Abstract
Primary central nervous system tumors (PCNST) are rare tumors responsible for high mortality and morbidity. Their epidemiology is poorly known, and clinical data are scarcely analyzed at a national level. In this study, we aimed at providing descriptive epidemiological data and incidence rates for all histological subtypes of PCNST according to the WHO classification. We conducted a nationwide population-based study of all newly diagnosed and histologically confirmed PCNST in France, between 2006 and 2011. A total of 57,816 patients were included: male 46.4%, median age at diagnosis 56 years old (range 0-99). For all newly diagnosed PCNST with histological confirmation the crude incidence rate was 15.5/105 per 100,000 person-years. To enable international comparisons, standardized rates were calculated: 14.1/105 (population of reference: USA), 14.5/105 (population of reference: Europe), and 12.0/105 (population of reference: world). 23.4% of samples were cryopreserved. Resection was performed in 79.1% of cases. Results are detailed (incidence rate, sex ratio, median age at diagnosis, number of cryopreserved samples, and type of surgery) for each of the 143 histological subtypes of PCNST, including all rare tumors. For example, incidence rates (population of reference: USA) were 0.018/105 for anaplastic gangliogliomas, 0.054/105 for malignant meningiomas, and 0.036/105 for hemangiopericytomas. Our study is the first to describe incidence rates and epidemiological data for all histological subtypes of PCNST, including rare tumors, at a national level. Its methodology ensures the exhaustiveness of the data collection for histologically-proven cases. Histological population-based studies have many perspectives in the field of clinical epidemiology and research.
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Affiliation(s)
- Amélie Darlix
- Department of Medical Oncology, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France.
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France.
| | - Sonia Zouaoui
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Valérie Rigau
- Department of Pathology, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Faiza Bessaoud
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Dominique Figarella-Branger
- Department of Neuropathology and INSERM U911, Timone Hospital, Université de la Méditerranée, 40 rue Ste Baume, 13010, Marseille, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Brigitte Trétarre
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Fabienne Bauchet
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Hugues Duffau
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Luc Taillandier
- Neuro-oncology Unit, University Hospital, 29 avenue du Maréchal de Lattre de Tassigny, Nancy, France
| | - Luc Bauchet
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
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Awake surgery for hemispheric low-grade gliomas: oncological, functional and methodological differences between pediatric and adult populations. Childs Nerv Syst 2016; 32:1861-74. [PMID: 27659829 DOI: 10.1007/s00381-016-3069-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Brain mapping through a direct cortical and subcortical electrical stimulation during an awake craniotomy has gained an increasing popularity as a powerful tool to prevent neurological deficit while increasing extent of resection of hemispheric diffuse low-grade gliomas in adults. However, few case reports or very limited series of awake surgery in children are currently available in the literature. METHODS In this paper, we review the oncological and functional differences between pediatric and adult populations, and the methodological specificities that may limit the use of awake mapping in pediatric low-grade glioma surgery. RESULTS This could be explained by the fact that pediatric low-grade gliomas have a different epidemiology and biologic behavior in comparison to adults, with pilocytic astrocytomas (WHO grade I glioma) as the most frequent histotype, and with WHO grade II gliomas less prone to anaplastic transformation than their adult counterparts. In addition, aside from the issue of poor collaboration of younger children under 10 years of age, some anatomical and functional peculiarities of children developing brain (cortical and subcortical myelination, maturation of neural networks and of specialized cortical areas) can influence direct electrical stimulation methodology and sensitivity, limiting its use in children. CONCLUSIONS Therefore, even though awake procedure with cortical and axonal stimulation mapping can be adapted in a specific subgroup of children with a diffuse glioma from the age of 10 years, only few pediatric patients are nonetheless candidates for awake brain surgery.
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22
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Boone M, Roussel M, Chauffert B, Le Gars D, Godefroy O. Prevalence and profile of cognitive impairment in adult glioma: a sensitivity analysis. J Neurooncol 2016; 129:123-30. [DOI: 10.1007/s11060-016-2152-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/19/2016] [Indexed: 11/29/2022]
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23
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Fountain DM, Allen D, Joannides AJ, Nandi D, Santarius T, Chari A. Reporting of patient-reported health-related quality of life in adults with diffuse low-grade glioma: a systematic review. Neuro Oncol 2016; 18:1475-1486. [PMID: 27194147 DOI: 10.1093/neuonc/now107] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/19/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Patient-reported health-related quality of life (HRQoL) analysis can provide important information for managing the balance between treatment benefits and treatment-related adverse effects on quality of life (QoL). This systematic review sought to identify the range of HRQoL measures used for patients with diffuse hemispheric WHO grade II glioma (DLGG) and assess the quality of HRQoL reporting. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for full-text English articles reporting HRQoL outcomes in adult patients with DLGG. RESULTS Eleven different QoL measures were used across the 26 included studies, none of which has been validated in patients with DLGG. Heterogeneity of study design prevented pooled analysis of data investigating the effect of interventions or establishing long-term HRQoL. Low rates of participation at baseline (mean: 64.0%) and high rates of subsequent dropout (2.1% per month) were identified. Five studies gave statistical methods to deal with missing data or provided evidence of clinical significance of HRQoL results. CONCLUSIONS The results demonstrate a paucity and heterogeneity of reporting of HRQoL in the DLGG literature, highlighting the need for a standardized assessment schedule and set of validated quality-of-life measures for future studies.
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Affiliation(s)
- Daniel M Fountain
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
| | - Dominic Allen
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
| | - Alexis J Joannides
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
| | - Dipankar Nandi
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
| | - Thomas Santarius
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
| | - Aswin Chari
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (D.M.F., A.J.J., T.S.); Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (D.M.F, A.J.J, T.S); Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK (D.A, D.N, A.C); Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK (D.A, D.N, A.C)
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24
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Magro E, Bergot L, Cuchard S, Lebreton S, Coutte MB, Rolland-Lozachmeur G, Hieu PD, Seizeur R. Diagnosis Disclosure Process in Patients With Malignant Brain Tumors. Clin J Oncol Nurs 2016; 20:E49-54. [PMID: 26991723 DOI: 10.1188/16.cjon.e49-e54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The way to disclose a cancer diagnosis has evolved, and psycho-oncology has developed a more prominent place in cancer care. The diagnosis disclosure process was established to improve the overall quality of patient care and the communication about a cancer diagnosis. OBJECTIVES The aim of this study was to assess the implementation of the disclosure process in a neurosurgical unit. METHODS This study was conducted prospectively during a one-year period. All patients were diagnosed with malignant brain tumors and received their diagnosis using the disclosure process. The communication between the provider and the patient during diagnosis disclosure was recorded for analysis, and patients completed a satisfaction survey. FINDINGS Ninety-one patients with a brain tumor diagnosis participated in the study. Twenty-six were unable to complete the satisfaction survey because they were either deceased or close to the end of their lives. In total, 65 questionnaires were sent to patients and their families, and 43 responded. Patients were satisfied with the quality of the disclosure process regarding information given, psychological support, and communication with all healthcare providers. This assessment allowed the authors to better characterize the impact of the disclosure process on the overall care of patients and to measure the effect of the components of the disclosure process on patient satisfaction.
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Affiliation(s)
- Elsa Magro
- Centre Hospitalier Regional Universitare
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25
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Henaine AM, Paubel N, Ducray F, Diebold G, Frappaz D, Guyotat J, Cartalat-Carel S, Aulagner G, Hartmann D, Honnorat J, Armoiry X. Current trends in the management of glioblastoma in a French University Hospital and associated direct costs. J Clin Pharm Ther 2016; 41:47-53. [PMID: 26748577 DOI: 10.1111/jcpt.12346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/03/2015] [Indexed: 11/29/2022]
Abstract
WHAT IS NEW AND OBJECTIVES Trends in the care of glioblastoma in actual practice settings are poorly described. In a previous pharmacoepidemiologic study, we highlighted changes in the management of patients with glioblastoma (GBM) newly diagnosed between 2004 and 2008. Our aim was to complete and to extend the previous report with a study of a cohort of patients diagnosed in 2011 to emphasize the trends in the pharmacotherapy of GBM over the last decade. METHODS A single-centre study was undertaken of three historic cohorts of GBM patients newly diagnosed during years 2004, 2008 and 2011 (corresponding to groups 1, 2 and 3, respectively) but limited to patients eligible for radiotherapy after initial diagnosis. The type of medical management was described and compared, as well as overall survival and total cost from diagnosis to death or the last follow-up date. Cost analysis was performed from the French sickness fund perspective using tariffs from 2014. RESULTS Two hundred and seventeen patients (49 in Group 1, 73 in Group 2, 95 in Group 3) were selected with similar baseline characteristics. Fluorescence-guided surgery using 5-ALA was increasingly used over the three periods. There was a strong trend towards broader use of temozolomide radiochemotherapy (39%, 73% and 83% of patients, respectively) as first-line treatment as well as bevacizumab regimen at recurrence (6%, 48% and 58% of patients, respectively). The increase in overall survival between Group 2 and Group 1 was confirmed for patients in Group 3 (17·5 months vs. 10 months in Group 1). The mean total cost per patient was 53368 € in Group 1, 70 201 € in Group 2 and 78355 € in Group 3. Hospital care represented the largest expenditure (75%, 59% and 60% in groups 1, 2 and 3, respectively) followed by chemotherapy drug costs (11%, 30% and 29%, respectively). WHAT IS NEW AND CONCLUSION This is the first study to report on changes in the management of GBM in real-life practice. The ten-year study indicates an improvement in overall survival but also an increase in total cost of care. The data should be useful for informing the care of GBM patients in settings similar to ours.
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Affiliation(s)
- A M Henaine
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France
| | - N Paubel
- Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - F Ducray
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Neuroscience Research Center INSERM U1028/CNRS UMR 5292, University Claude Bernard Lyon 1, Lyon, France
| | - G Diebold
- Pharmacy Department, Centre Hospitalier de Roanne, Roanne, France
| | - D Frappaz
- Department of Pediatric and Adult Neuro-Oncology, Centre Léon Bérard, Lyon, France
| | - J Guyotat
- Neurosurgery Department, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - S Cartalat-Carel
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Neuroscience Research Center INSERM U1028/CNRS UMR 5292, University Claude Bernard Lyon 1, Lyon, France
| | - G Aulagner
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France.,Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - D Hartmann
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France
| | - J Honnorat
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - X Armoiry
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France.,Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation, Lyon, France
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Vigneron C, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Helfre S, Alapetite C, Coca A, Kehrli P, Noël G. [Evolution of the management of pediatric and adult medulloblastoma]. Cancer Radiother 2015; 19:347-57; quiz 358-9, 362. [PMID: 26141663 DOI: 10.1016/j.canrad.2015.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 01/05/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
Medulloblastoma are cerebellar tumours belonging to the group of primitive neuroectodermal tumours (PNET) and are the most common malignant brain tumours of childhood. These tumours are rare and heterogeneous, requiring some multicentric prospective studies and multidisciplinary care. The classical therapeutic approaches are based on clinical, radiological and surgical data. They involve surgery, radiation therapy and chemotherapy. Some histological features were added to characterize risk. More recently, molecular knowledge has allowed to devise risk-adapted strategies and helped to define groups with good outcome and reduce long-term sequelae, improve the prognostic of high-risk medulloblastoma and develop new therapeutic tools.
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Affiliation(s)
- C Vigneron
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France
| | - N Entz-Werlé
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Lutz
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Spiegel
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Jannier
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Helfre
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - C Alapetite
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - A Coca
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Kehrli
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - G Noël
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France.
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Deiana G, Mottolese C, Hermier M, Louis-Tisserand G, Berthezene Y. Imagery of pineal tumors. Neurochirurgie 2015; 61:113-22. [DOI: 10.1016/j.neuchi.2014.10.111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 10/13/2014] [Accepted: 10/15/2014] [Indexed: 12/26/2022]
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[The stem cell niche in glioblastoma: from fundamental aspects to targeted therapies]. Bull Cancer 2015; 102:24-33. [PMID: 25609493 DOI: 10.1016/j.bulcan.2014.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 07/21/2014] [Indexed: 12/11/2022]
Abstract
The concept of cancer stem cell (CSC) was established from models of leukemogenesis explaining tumor repopulation by the clonogenic properties of this specific population of tumoral cells. Among solid tumors, glioblastoma are currently the most documented models. Cancer stem cells reside in specific locations within tumors called niches. Anatomically, two complementary niches have been described in glioblastoma. The first one is a perivascular niche composed of vessels (endothelial cells, pericytes) and their microenvironment (integrins, interleukins) constitutive the nest of "normal" neural stem cells and cancer stem cells. The second one is a hypoxic niche found in regions with low oxygen tension such as the core of the tumor. In these niches, mutual interactions between CSC and their microenvironment involving the activation of multiple signaling pathways promote stemness maintenance and tumor propagation. The median overall survival of glioblastoma does not exceed 15 months despite an aggressive multimodal treatment, thus the therapeutic targeting of these niches, by systemic agents or radiotherapy, in order to inhibit the signaling pathways involved in the maintenance of the CSC niches, represents a major challenge. The combination of these two strategies appears promising and many clinical trials are underway.
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Diebold G, Ducray F, Henaine AM, Frappaz D, Guyotat J, Cartalat-Carel S, Breant V, Fouquet A, Aulagner G, Honnorat J, Armoiry X. Management of glioblastoma: comparison of clinical practices and cost-effectiveness in two cohorts of patients (2008 versus 2004) diagnosed in a French university hospital. J Clin Pharm Ther 2014; 39:642-8. [PMID: 25164371 DOI: 10.1111/jcpt.12199] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 07/30/2014] [Indexed: 12/20/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Therapeutic options for the management of glioblastoma (GBM) have greatly evolved over the last decade with the emergence of new regimens combining radiotherapy plus temozolomide and the use of bevacizumab at recurrence. Our aim was to assess the clinical and economic impacts of those novel strategies in our center. METHODS A single-center retrospective chart review was conducted on patients newly diagnosed with a GBM over two periods (year 2004, group 1 or year 2008, group 2) with limitations to those eligible to radiotherapy after initial diagnosis. The type of medical management was described and compared, as well as overall survival and total costs from diagnosis to death or the last follow-up date. Cost analysis was performed under the French Sickness Fund perspective using tariffs from 2012. RESULTS One hundred twenty-two patients were selected (49 in group 1 and 73 in group 2) with similar baseline characteristics within the two groups. Patients from group 2 received more frequently temozolomide radiochemotherapy (71% vs. 39%, P < 0·05) as first-line treatment as well as bevacizumab regimen at recurrence (48% vs. 6%, P < 0·05); the median overall survival was increased between the two periods (respectively 17 vs. 10 months, P < 0·05). The mean total cost per patient was 54,388 € in group 1 and 71,148 € in group 2 (P < 0·05). Hospital care represented the largest expenditure (76% and 58% in groups 1 and 2 respectively) followed by chemotherapy drugs costs (11% and 30% respectively). The total cost difference between the two groups was explained by the increasing use of temozolomide and bevacizumab. The incremental cost-effectiveness ratio was estimated at 54,355 € per life-year gained. WHAT IS NEW AND CONCLUSION As far as we know, this is the first study reporting the total cost of GBM management based on the French perspective, as well as the cost-effectiveness of clinical practices in term of cost per life-year gained. Those novel strategies have contributed to improve overall survival while inducing a substantial, but acceptable, increase of total costs.
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Affiliation(s)
- G Diebold
- Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
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Significant heterogeneity in the geographical distribution of diffuse grade II/III gliomas in France. J Neurooncol 2014; 120:547-55. [DOI: 10.1007/s11060-014-1585-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 08/09/2014] [Indexed: 01/27/2023]
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Benouaich-Amiel A, Catalaa I, Lubrano V, Cohen-Jonathan Moyal E, Uro-Coste E. Glioma di alto grado: astrocitoma anaplastico e glioblastoma. Neurologia 2014. [DOI: 10.1016/s1634-7072(14)67978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bauchet L, Zouaoui S, Darlix A, Menjot de Champfleur N, Ferreira E, Fabbro M, Kerr C, Taillandier L. Assessment and treatment relevance in elderly glioblastoma patients. Neuro Oncol 2014; 16:1459-68. [PMID: 24792440 DOI: 10.1093/neuonc/nou063] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Glioblastoma (GBM) is the most common malignant primary brain tumor. Its incidence continues to increase in the elderly because the older segment of the population is growing faster than any other age group. Most clinical studies exclude elderly patients, and "standards of care" do not exist for GBM patients aged >70 years. We review epidemiology, tumor biology/molecular factors, prognostic factors (clinical, imaging data, therapeutics), and their assessments as well as classic and specific endpoints plus recent and ongoing clinical trials for elderly GBM patients. This work includes perspectives and personal opinions on this topic. Although there are no standards of care for elderly GBM patients, we can hypothesize that (i) Karnofsky performance status (KPS), probably after steroid treatment, is one of the most important clinical factors for determining our oncological strategy; (ii) resection is superior to biopsy, at least in selected patients (depending on location of the tumor and associated comorbidities); (iii) specific schedules of radiotherapy yield a modest but significant improvement; (iv) temozolomide has an acceptable tolerance, even when KPS <70, and could be proposed for methylated elderly GBM patients; and (v) the addition of concomitant temozolomide to radiotherapy has not yet been validated but shows promising results in some studies, yet the optimal schedule of radiotherapy remains to be determined. In the future, specific assessments (geriatric, imaging, biology) and use of new endpoints (quality of life and toxicity measures) will aid clinicians in determining the balance of potential benefits and risks of each oncological strategy.
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Affiliation(s)
- Luc Bauchet
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Sonia Zouaoui
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Amélie Darlix
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Nicolas Menjot de Champfleur
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Ernestine Ferreira
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Michel Fabbro
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Christine Kerr
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
| | - Luc Taillandier
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France (L.B., S.Z.); French Brain Tumor DataBase, ICM, Montpellier, France (L.B., S.Z., A.D.); Department of Neuroradiology, CHU, Montpellier, France (N.M. deC.); Department of Geriatrics, CHU, Montpellier, France (E.F.); Department of Medical Oncology, ICM, Montpellier, France (A.D., M.F.); Department of Radiation Oncology, ICM, Montpellier, France (C.K.); Department of Neurology, CHU, Poitiers, France (L.T.)
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Mandonnet E, de Witt Hamer P, Pallud J, Bauchet L, Whittle I, Duffau H. Silent diffuse low-grade glioma: Toward screening and preventive treatment? Cancer 2014; 120:1758-62. [DOI: 10.1002/cncr.28610] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/16/2013] [Accepted: 12/12/2013] [Indexed: 01/20/2023]
Affiliation(s)
- Emmanuel Mandonnet
- Department of Neurosurgery; Lariboisiere Hospital; Paris France
- University of Paris 7; Paris France
- Imaging and Modeling Laboratory for Neurobiology and Oncology; Medical Research Unit 8165; Orsay France
| | - Philip de Witt Hamer
- Department of Neurosurgery; VU University Medical Center; Amsterdam the Netherlands
| | - Johan Pallud
- Department of Neurosurgery; Saint-Anne Hospital; Paris France
- University of Paris 5; Paris France
| | - Luc Bauchet
- Department of Neurosurgery; Gui de Chauliac Hospital; Montpellier Medical University Center; Montpellier France
| | - Ian Whittle
- Department of Clinical Neurosciences; University of Edinburgh; Edinburgh United Kingdom
| | - Hugues Duffau
- Department of Neurosurgery; Gui de Chauliac Hospital; Montpellier Medical University Center; Montpellier France
- Institute of Health and Medical Research Unit 1051, Institute of Neuroscience of Montpellier; Montpellier France
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Oncological patterns of care and outcomes for 265 elderly patients with newly diagnosed glioblastoma in France. Neurosurg Rev 2014; 37:415-23; discussion 423-4. [DOI: 10.1007/s10143-014-0528-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 10/28/2013] [Accepted: 10/29/2013] [Indexed: 10/25/2022]
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